Psychosomatic consultation-liaison service in a medical out-patient department. Experience with a random sample of patients.

A sample of 103 patients was chosen at random from those attending the Hamburg University medical out-patient clinic. As well as undergoing the usual diagnostic procedures, these patients were interviewed to establish whether psychosomatic factors were also involved. The results show that a high percentage of the patients was willing to accept that psychological and/or social factors played a role in their illness. There was, however, a significant negative correlation between this willingness and the length of time the illness had persisted. In 50% of the patients the clinical diagnostic procedures revealed no signs of a pathological organic condition. Approximately one quarter of the patients were suffering from psychosomatic disorders in the strict sense of the word. Almost a third of the patients received psychotherapeutic help after the diagnostic procedures had been completed. The vital importance of cooperation from the outset between medical clinicians and psychotherapists is discussed in the light of empirical findings on iatrogenic chronification and its financial and personal implications for the medical services and their patients.